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Published on: 2/10/2026
In women 65 and older, tuberculosis often shows up quietly rather than dramatically, with a cough lasting 3 or more weeks, shortness of breath, fatigue, unintended weight loss, low fevers or night sweats, and it may also appear outside the lungs as swollen neck lymph nodes or persistent back or joint pain. There are several factors to consider, including when to seek testing, how symptoms differ in seniors, and what treatments and precautions help recovery and prevent complications; see the complete guidance below for key details that can shape your next healthcare steps.
Tuberculosis (often called TB) is an infectious disease that still affects older adults in the United States and worldwide. While many people think of TB as a disease of the past, it remains important today—especially for women age 65 and older. Aging changes the immune system, and symptoms of Tuberculosis in seniors can look different than they do in younger adults. Understanding what to watch for can help women get care earlier and avoid serious complications.
This guide uses information from widely accepted medical authorities such as the CDC, WHO, and geriatric health research, presented in clear, everyday language.
Tuberculosis is an infection caused by the bacterium Mycobacterium tuberculosis. It most often affects the lungs (pulmonary Tuberculosis), but it can also involve other parts of the body, including:
TB spreads through the air when a person with active lung TB coughs, speaks, or sings. It is not spread by touching surfaces, sharing dishes, or casual contact.
As we age, our immune system naturally becomes less responsive. This can allow a long-dormant TB infection—called latent Tuberculosis—to become active later in life.
Women 65 and older may be at higher risk if they:
Because symptoms can be subtle or mistaken for "normal aging," Tuberculosis in seniors is sometimes diagnosed later than it should be.
Symptoms of Tuberculosis in older women are often less dramatic than the classic coughing-blood image many people associate with TB. Instead, they may develop slowly and quietly.
These are the most common symptoms, but they may be mild at first:
Some older women may not have much of a cough at all, which can delay diagnosis.
TB often affects the whole body, not just the lungs. In seniors, these signs are sometimes mistaken for aging or other illnesses:
These symptoms may come and go, which can make them easy to dismiss.
In older adults, Tuberculosis is more likely to appear outside the lungs, a condition called extrapulmonary TB.
This form may not cause coughing or breathing problems at all.
This can be mistaken for arthritis or osteoporosis.
Depending on the area involved, symptoms may include:
Because these symptoms overlap with many other conditions, TB is sometimes overlooked unless testing is done.
Older women may experience:
Hormonal changes, lower muscle mass, and chronic health conditions can all influence how Tuberculosis shows up in seniors.
You do not need to panic, but certain symptoms should not be ignored, especially if they last more than a few weeks:
If symptoms are sudden, severe, or affecting breathing or alertness, speak to a doctor right away, as these could be life-threatening.
Doctors use several tools to diagnose Tuberculosis:
Testing is especially important for older women because early treatment greatly improves outcomes.
If you're experiencing any of the symptoms mentioned above and want to understand whether they could be related to TB, Ubie offers a free, AI-powered Tuberculosis (TB) (Including Scrofuloderma) symptom checker that can help you assess your symptoms in just a few minutes and guide you on whether to seek medical attention.
Tuberculosis is treatable, even in older adults. Treatment usually involves:
For women 65+, doctors carefully choose medications and monitor liver function and other health factors. Finishing the full course of treatment is essential, even if symptoms improve early.
While not all TB cases can be prevented, these steps help reduce risk:
Living an active, well-supported life helps the immune system work more effectively.
Tuberculosis can be serious, but it is not a reason for fear. Many women over 65 are diagnosed and treated successfully, especially when symptoms are recognized early. The biggest risk comes from ignoring changes in your health or assuming symptoms are "just aging."
If something feels off, trust that instinct.
In summary: Tuberculosis in women 65+ often appears subtly, with fatigue, weight loss, or mild respiratory symptoms rather than dramatic illness. Knowing what to watch for—and acting when something doesn't feel right—helps protect both your health and your independence.
(References)
* Cheng A, Li T, Wang W, Liu Y, Zhang S, Sun H, Huang M, Li W, Wang H, Wang S. Clinical features and outcome of tuberculosis in older adults compared with young adults: a retrospective study. Arch Gerontol Geriatr. 2019 Jan;80:88-93. doi: 10.1016/j.archger.2018.11.002. Epub 2018 Nov 14. PMID: 30449491.
* Rajagopalan S. Tuberculosis in the elderly: A review of the literature. F1000Res. 2020 Jul 15;9:F1000 Faculty Rev-666. doi: 10.12688/f1000research.24647.1. PMID: 33946356; PMCID: PMC8060378.
* Sreeram V, Rajendran P, George N, Ponnambath G, Purayil B, Sasidharan V. Challenges in the diagnosis and management of tuberculosis in elderly patients. J Fam Med Prim Care. 2016 Jan-Mar;5(1):11-5. doi: 10.4103/2249-4863.184620. PMID: 27457004; PMCID: PMC4944372.
* Chen CY, Lu PL, Hu ML, Lin CY, Tsai YW, Lo SF. Clinical and laboratory characteristics of tuberculosis in patients aged ≥70 years: a retrospective cohort study. BMC Infect Dis. 2019 Feb 11;19(1):151. doi: 10.1186/s12879-019-3783-9. PMID: 30745269; PMCID: PMC6371515.
* Al-Jahdali HH, Al-Johani SM, Baharoon S, Al-Ghamdi A. Tuberculosis in the elderly: a forgotten disease? A review of epidemiology, clinical features and treatment. J Infect Public Health. 2014 Dec;7(6):448-54. doi: 10.1016/j.jiph.2014.02.007. Epub 2014 Mar 4. PMID: 24584447.
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